Assessment of biofilm growth on voice prostheses using a tracheoesophageal fistula simulator

Introduction: Voice prostheses (VPs) are devices that are widely used in voice rehabilitation of patients after laryngectomy. The main cause of VPs failure is their destruction by the growth of biofilm, mainly fungal. Aim: The aim of this study was to design and build a tracheoesophageal fistula (TEF) simulator to observe and analyse the process of biofilm formation on voice prostheses and its effect on the structure of the material from which they are made, in conditions as close to real as possible. Methods: Biofilm cultures were performed on voice prostheses under controlled in vitro conditions using a TEF simulator. Then, the crystal violet staining and confocal microscopic examination were performed. Results: The analysis of voice prostheses cultured in the TEF simulator conditions confirmed the presence of biofilm on their surface. Conclusions: The TEF simulator can be a valuable tool for future studies of silicone modifications that can limit the growth of biofilm on the VPs.